Quality of Life, Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal

Badihian, Shervin; Jalalpour, Pouyan; Motahareh, Mirdamadi; Moslehi, Masoud

doi:10.14735/amko2016439

Cited by 19 publications

(17 citation statements)

References 25 publications

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“…To stimulate the uptake of 131-I by cancer cells, an increase in serum TSH levels is needed and this, nowadays, can be obtained either by withdrawing levo-thyroxine (LT4) therapy, with the consequent increase of endogenous TSH, or by administrating recombinant human TSH (rhTSH), an exogenous molecule obtained by recombinant DNA technology (2,3,4,5). The withdrawal of LT-4 therapy induces hypothyroidism that determines consistent negative effects on patients' quality of life (QofL) and social costs (6,7,8,9). Numerous studies already demonstrated rhTSH to be a valid alternative to the LT-4 therapy withdrawal in DTC follow-up and treatment (10,11,12,13,14).…”

Section: Introductionmentioning

confidence: 99%

No difference in the outcome of metastatic thyroid cancer patients when using recombinant or endogenous TSH

Campopiano¹,

Podestà²,

Bianchi

et al. 2020

European Journal of Endocrinology

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Objective: At the present, recombinant TSH cannot be used for the treatment of metastatic differentiated thyroid cancer patients. Aim of this study was to evaluate if the type of TSH stimulation, recombinant or endogenous, had an impact on the outcome of these patients. Design and methods: We compared the outcome of two propensity score-matched groups of metastatic patients, stimulated by either only recombinant TSH (n=43) or only endogenous TSH (n=34). Results: As expected from the matching procedure, the clinical-pathological features and the cumulative 131I-activities administered of the two groups were very similar. After 4 years of follow-up 4% of patients were cured, 3% had biochemical disease and 93% had structural disease. However, 91% of patients obtained a clinical benefit from this therapy in terms of stabilization of the disease or complete remission or partial response. When considering the two groups separately we did not find any difference in their outcome. When considering the response to 131-I therapy of the single type of metastases, 8% of lymph node metastases and 8% of lung metastases disappeared but none of bone metastases. The response to 131-I therapy of the single type of metastases was similar when we looked at the two groups separately. Conclusions: this study shows a) an overall clinical benefit of the 131-I therapy since the majority of patients remained affected but with a stable disease b) the preparation with either recombinant or endogenous TSH has no impact on the 131-I therapy efficacy and the outcome of our two groups of patients.

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Section: Introductionmentioning

confidence: 99%

No difference in the outcome of metastatic thyroid cancer patients when using recombinant or endogenous TSH

Campopiano¹,

Podestà²,

Bianchi

et al. 2020

European Journal of Endocrinology

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“…A significant decrease in HRQOL following the onset of hypothyroid symptoms after THW in preparation for therapy or imaging was frequently reported. 10 , 34 – 45 The cross-sectional study by Tagay et al 40 demonstrated overall anxiety and depression prevalence of 63% and 17%, respectively, in patients undergoing THW. Rubic et al 10 found significant negative determinants of HRQOL at the time of diagnosis: fear of metastases, family distress, and the need for surgery/RIA.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of health-related quality of life following thyroid cancer

Walshaw

Smith

Kim

et al. 2021

Tumori

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This systematic review provides a summary of all studies published between 2000 and 2019 using a health-related quality of life (HRQOL) patient-completed questionnaire to report outcomes following diagnosis and treatment of thyroid cancer. The search terms were “thyroid cancer” or “thyroid carcinoma,” “quality of life” or “health related quality of life,” and “questionnaire” or “patient reported outcome.” EMBASE, PubMed, Medline, PsycINFO, CINAHL, and HaNDLE-On-QOL search engines were searched between 2 February and 23 February 2020. A total of 811 identified articles were reduced to 314 when duplicates were removed. After exclusion criteria (not thyroid specific, no quality of life questionnaires, and conference abstracts) were applied, 92 remained. Hand searching identified a further 2 articles. Of the 94 included, 16 had a surgical, 26 a primarily medical, and 52 a general focus. There were articles from 27 countries. A total of 49 articles were published from 2015 through 2019 inclusive. A total of 72 questionnaires were used among the articles and a range of 7 to 2215 participants were included within each article. This review demonstrated an increasing number of publications annually. The scope of enquiry into aspects of HRQOL following thyroid cancer is broad, with relatively few addressing surgical aspects and many focusing on the impact of radio-iodine. More research is required into shared decision-making in initial management decisions and HRQOL and interventions aimed specifically at addressing long-term HRQOL difficulties.

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“…14 Current data or studies are conflicting whether anxiety and/or depression have direct effect on cognitive performance thus was assessed in this study. 4,16 Data were analyzed using IBM Statistical Package for the Social Sciences V26. The mean scores for TSH, MoCA-P, HADS-P total score, HADS-P depression, HADS-P anxiety, and different cognitive domains were calculated for each time frame (baseline, hypothyroid state, post LT4 treatment).…”

Section: Methodsmentioning

confidence: 99%

“…3 Other patients experience anxiety and depression and are associated with a decreased quality of life. 4 The pathogenesis of cognitive dysfunction in hypothyroidism is still unknown but some studies show a decrease in cerebral blood flow and decreased cerebral oxygen and glucose metabolism seen in single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans. 5,6 Animal studies suggest that hypothyroidism can produce alterations in the synaptic plasticity of neural pathways mediated by the dorsal hippocampus, which is an important area for many higher cognitive functions.…”

Section: Introductionmentioning

confidence: 99%

Evaluating cognitive function in patients with differentiated thyroid cancer who experienced short- term hypothyroidism by levothyroxine withdrawal using Montreal Cognitive Assessment-Philippines (MoCA-P) tool

Israel¹,

Cunanan²,

Galan³

et al. 2023

NeuroAsia

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Background & Objective: Although there are numerous data studying cognitive dysfunction on hypothyroidism in general, there are limited researches that venture on short-term hypothyroidism. This study aimed to determine the cognitive function of patients with differentiated thyroid cancer (DTC) who experienced short-term hypothyroidism. Methods: This was a prospective study done in a tertiary hospital in Manila that enrolled 16 DTC patients either for radioactive iodine (RAI) therapy or thyroid cancer monitoring, who were followed at baseline before levothyroxine (LT4) withdrawal, during hypothyroid state and post-LT4 treatment. MoCA-P tool was used to objectively assess cognition while HADS-P tool was used to detect anxiety and depression. Mean scores were calculated for each time point and analyzed using paired T-test. Results: There was a decrease in the mean MoCA-P score from baseline to hypothyroid state (25.22 to 22.97, p= 0.032) with improvement post-LT4 treatment (22.97 to 24.93, p= 0.004). Older age was associated with decrease in MoCA-P scores (p= 0.04). Total HADS-P scores were nonsignificant. Visuospatial (3.86 to 3.43, p 0.014) and attention (4.86 to 4.36, p value 0.021) domains declined with hypothyroidism, with reversal of visuospatial function post-LT4 treatment. Conclusion: There is a significant alteration in cognition during short-term hypothyroidism that generally improves with LT4 treatment. It is important to educate patients on specific cognitive domains that can be affected to ensure occupational safety.

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Quality of Life, Anxiety and Depression in Patients with Differentiated Thyroid Cancer under Short Term Hypothyroidism Induced by Levothyroxine Withdrawal

Cited by 19 publications

References 25 publications

No difference in the outcome of metastatic thyroid cancer patients when using recombinant or endogenous TSH

No difference in the outcome of metastatic thyroid cancer patients when using recombinant or endogenous TSH

Systematic review of health-related quality of life following thyroid cancer

Evaluating cognitive function in patients with differentiated thyroid cancer who experienced short- term hypothyroidism by levothyroxine withdrawal using Montreal Cognitive Assessment-Philippines (MoCA-P) tool

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